Thursday, June 21, 2007

When I tell people I had RFA to treat a metastatic tumour in my liver they invariably ask... “What the H--- is RFA?” When I tell them that it is "Radio Frequency Ablation" they nod politely. When I try to explain by saying… “an alternating current is sent though electrodes inserted into the tumour resulting in coagulative necrosis of the malignant tissue” their eyes glaze over and they wish they could change the subject.

But RFA is just too cool not to talk about! It is one of those great new techniques that is changing how we approach small tumours in the liver and other locations. So here, in a nutshell, is a concise description of RFA. (with help from Medicinenet.com)

First let’s unpack the term.

Ablation: “Removal or excision. Ablation is usually carried out surgically. For example, surgical removal of the thyroid gland (a total thyroidectomy) is ablation of the thyroid. The word ablation comes from the Latin ablatum meaning to carry away.” Medicinenet.com

The geologists among us will of course recognize "ablation" as also referring to the erosional processes by which a glacier is reduced, thus yielding… “ablation till”. Fascinating as this is, I digress…Radiofrequency ablation: “The use of electrodes to generate heat and destroy abnormal tissue. In radiofrequency ablation (RFA), heat is generated locally by a high frequency, alternating current that flows from the electrodes. A probe is inserted into the center of the tumor and the non-insulated electrodes, which are shaped like prongs, are projected into the tumor. The local heat that is generated melts the tissue (coagulative necrosis) that is adjacent to the probe. This results in a 3 cm to 5.5 cm sphere of dead tissue per treatment session. The probe is left in place for about 10 to 15 minutes.” Medicinenet.com

One of the really great things about RFA is that it can often be administered "percutaneously", or through the skin, making it a “minimally invasive” procedure. In my case, because of the tumour location, RFA was administered within open surgery. Several deployments of the probe were needed to create a "zone of ablation" large enough to encompass the whole tumour and allow for clear margins. A follow-up CT taken a couple of months later showed that the "zone of ablation", or "sphere of dead tissue", did completely encompass the pre-existent tumour (whew!!). I’m now taking Chemo to clean up any microscopic metastases that may be in the area. I'll be having regular CT scans down the road to keep an eye on things.

Now when people ask "What is RFA?". I just say... "We burnt that little sucker right out of there!!"

Friday, June 15, 2007

Chemotherapy is standard fare for many survivors. Any cancers that have spread, or are at risk of spreading, beyond the local site seem to be candidates for chemo. Just the very thought of chemo conjures up feelings of nausea and dread for many. Horror stories abound!! Many, but not all, of them true! I'm currently in the midst of my second round of chemo treatment. My first round, in 2004/05, lasted for 6 months and included the intravenous infusion of 3 or 4 different drugs administered for 2 days every 2 weeks. My current regime includes the intravenous infusion of 2 drugs and a 2-week cycle of an oral chemo in tablet form, all followed by a week off. My current chemo program is to reduce the possibility of future recurrences.

I'm amazed at the incredible variety of chemo drugs that are being used to fight cancer. And there are new ones coming online all the time. One of the new drugs I am taking today wasn't even available 3 years ago. It is the job of the oncologist to pick from these various drugs and to plan, prescribe, and administer the chemo program. A good oncologist is vital to an effective medical team. I'm lucky to have one of the best!!

It's the side effects that get us!! And how!! Side effects can include nausea, vomiting, diarrhea, constipation, hairloss, mouth sores, hand and foot sores, anemia, low white blood count, and low platlet count. Side effects vary widely from patient to patient and drug to drug. There are very effective drugs to counter the various side effects and the chemo dose can be reduced if side effects get too bad. My side effects have been varied. I've lost my hair, nausea and diarrhea are pretty standard, and my white blood cells and platelets have both declined. I'm taking another drug (Neupogen) to boost the white blood cells. Overall, though it's not too bad. My appetite is good, I have many good days, and CANCER IS BEING BEATEN!!.YAH!!

I remember a young women at a cancer workshop reflecting on the chemo program ahead of her. "I've got this horrible disease but there is this medicine that can help me. It may have some nasty side-effects but it can help me to be well again. It is the medicine I need."

Have a great weekend!.... Rob

------------------------"Yesterday I decided to go to the office. I got as far as the bedroom door. Chemo strikes." Peter Jennings

Welcome

In 2004 I was diagnosed with metastatic colon cancer. This blog was created in 2007, during which time I was being treated for a recurrence. Now, in 2012, I am in treatment for a persistent recurrence in my sacrum.In here you will find personal stories, reflections, inspiring videos, great music, and cancer humour.Blessings...Rob

Merton In Asia

I started a blog to explore the life and legacy of 20th Century author and Trappist monk Thomas Merton. In particular, I looked at his journey to Asia in 1968 and viewed his published journals from that period as a window on his life and message.